NEW: Making Care Primary (MCP) Model

Webinar September 14th 12 Noon EST

Making Care Primary (MCP) Model Overview

Register Here

On June 8, 2023, the Centers for Medicare & Medicaid Services (CMS) announced a new voluntary primary care model – the Making Care Primary (MCP) Model – that will be tested in eight states. Launching July 1, 2024, the 10.5-year model involves CMS working with State Medicaid Agencies.

CMS is accepting applications from Medicare-enrolled organizations that provide primary care services to Medicare beneficiaries, including solo primary care practices, group practices, health systems, eligible Indian Health Programs, and FQHCs located in the following states:

• Colorado,
• Massachusetts,
• Minnesota,
• New Mexico,
• New Jersey,
• upstate New York
• North Carolina,
• Washington

Model Design

MCP is a three-track model with one track reserved for organizations with no prior value-based care experience. 

• Track 1 – Payment for primary care will remain fee-for-service (FFS), while CMS provides additional financial support to help participants develop care transformation infrastructure and build advanced care delivery capabilities. Participants can begin earning financial rewards for improving patient health outcomes in this track.
• Track 2 – Payment for primary care will shift to a 50/50 blend of prospective, population-based payments and FFS payments. CMS will continue to provide additional financial support at a lower level than Track 1, as participants continue to build advanced care delivery capabilities. Participants will be able to earn increased financial rewards for improving patient health outcomes. 
•  Track 3 – Payment for primary care will shift to fully prospective, population-based payment while CMS will continue to provide additional financial support, at a lower level than Track 2, to sustain care delivery activities while participants have the opportunity to earn greater financial rewards for improving patient health outcomes.

Eligibility Criteria

To be eligible to apply to participate in MCP, an organization must:   

• Be a legal entity formed under applicable state, federal, or Tribal law authorized to conduct business in each state in which it operates.
• Be Medicare-enrolled.
• Bill for health services furnished to a minimum of 125 attributed Medicare beneficiaries. 
• Have the majority (at least 51%) of their primary care sites (physical locations where care is delivered) located in an MCP state.

The following organizations are ineligible to participate in MCP:

• PCF practices and ACO REACH Participant Providers that have not withdrawn or been terminated from either model as of 5/31/23.
• Grandfathered Tribal FQHCs
• Practices that provide concierge care
• Rural Health Clinics

Webinar September 14th 12 Noon EST

Making Care Primary (MCP) Model Overview

Register Here

Kris Gates, gates@healthendeavors.com